Infections caused by Enterobacterales have become more difficult to treat due to increasing antibiotic resistance, in particular, in the case of production of carbapenemases. Bacterial peritonitis is a common complication of peritoneal dialysis, being Citrobacter spp., an uncommon cause of this syndrome. We report the first case of bacterial peritonitis in continuous ambulatory peritoneal dialysis (CAPD) caused by Citrobacter werkmanii resistant to all beta-lactams, gentamicin, and cotrimoxazole, and also the new anti-gram-negative molecules ceftazidime/avibactam and ceftolozane/tazobactam. The molecular analysis of the strain demonstrated the presence of blaVIM metallo-β-lactamase gene. The patient was effectively cured with a course of systemic tigecycline, colistin, and meropenem.
